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BMC Palliative Care
Published in: BMC Palliative Care 1/2024

Open Access 01-12-2024 | Research

What helps or hinders effective end-of-life care in adult intensive care units in Middle Eastern countries? A systematic review

Authors: Nabat Almalki, Breidge Boyle, Peter O’Halloran

Published in: BMC Palliative Care | Issue 1/2024

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Abstract

Background

As many patients are spending their last days in critical care units, it is essential that they receive appropriate end-of -life care. However, cultural differences, ethical dilemmas and preference practices can arise in the intensive care settings during the end of life. Limiting therapy for dying patients in intensive care is a new concept with no legal definition and therefore there may be confusion in interpreting the terms ‘no resuscitation’ and ‘comfort care’ among physicians in Middle East. Therefore, the research question is ‘What helps or hinders effective end-of-life care in adult intensive care units in Middle Eastern countries?’

Methods

The authors conducted a comprehensive systematic literature review using five electronic databases. We identified primary studies from Medline, Embase, CINAHL, Psycinfo and Scopus. The team assessed the full-text papers included in the review for quality using the Joanna Briggs Institute checklist (JBI). We completed the literature search on the first of April 2022 and was not limited to a specific period.

Results

We identified and included nine relevant studies in the review. We identified five main themes as end-of-life care challenges and/or facilitators: organisational structure and management, (mis)understanding of end-of-life care, spirituality and religious practices for the dying, communication about end-of-life care, and the impact of the ICU environment.

Conclusions

This review has reported challenges and facilitators to providing end-of-life care in ICU and made initial recommendations for improving practice. These are certainly not unique to the Middle East but can be found throughout the international literature. However, the cultural context of Middle East and North Africa countries gives these areas of practice special challenges and opportunities. Further observational research is recommended to confirm or modify the results of this review, and with a view to developing and evaluating comprehensive interventions to promote end-of-life care in ICUs in the Middle East.
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Metadata
Title
What helps or hinders effective end-of-life care in adult intensive care units in Middle Eastern countries? A systematic review
Authors
Nabat Almalki
Breidge Boyle
Peter O’Halloran
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Palliative Care / Issue 1/2024
Electronic ISSN: 1472-684X
DOI
https://doi.org/10.1186/s12904-024-01413-7

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